HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 6705 Penny Lane
Property Tax ID #: 1301-611-0243-000-8
Site Plan Name:
Project flame: Zachary Tucker
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 13
Block No. 111
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ��Tb
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Zachary Tucker
Name: Scott Berman
Address: 6705 Penny Lane
Company: Florida Window & Door
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No. 772-940-1173
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax:
Phone No 561-340-4300
E-Mail: flahunter@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail howard@floridawindowanddoor.com
State or County License 28576
nr vague yr consuucnon is c�vu or more, a tttf-uKutu ntotice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:_
Address:
City:
Zip:
Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
State:
X Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lanriar nr an attornev before commencine work or recording vour Notice of Commencement.
Signature of Contractor License Holder
Si tune of Own essee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sr_ Lucie
COUNTY OF —eeacn
Sworn to (or affirmed) and subscribed before me of
S�rorn to (or affirmed) and subscribed before me of
Physical Pres nce or Online Notarization
?`Physical Pre ence or Online Notarization
this day
this � day of h!>_y
J(I— of _ �r
Zachary Tucker
Scott Berman
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known x OR Produced IdentificationTy
of Ident' cation
Type of Identification
f-'0
Pr du d (U
Pr uc
(Signatur Lary U. arycPU �tsera4 )
(Signature of -Notary Public- State of Florida)
N o
.Q
° Carol A Hammersla
w G)
Commiss riJ My Commission GG 3a34(al)
Commission No. (Seal)
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DATE
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COMPLETED
Rev. 5/6/20